Europe has recently pulled the trigger on their version of our Sunshine Act. While it is true that, with the exception of Denmark, France, and Portugal, the requirement to disclose does not have the force of law, information on money paid to individuals will be available for public scrutiny for the first time in Europe.
However, with the exception of those three aforementioned countries, pharmaceutical companies that are responsible for collecting the information must get consent from each individual healthcare professional or organization before they can publish it.
This move comes after a strong push by the European Federation of Pharmaceutical Industries and Associations (EFPIA). EFPIA, which has many major pharmaceutical companies among its members, has issued a minimum standard for what is required for disclosure for its members.
However, such a requirement that most countries involved require consent of professionals and organizations will likely result in differences in the level of compliance from country to country, and maybe even organization to organization. According to Andrew Powrie-Smith, responsible for implementation at EFPIA, “[t]here are differences in culture, differences in privacy law – Germany for instance has very strong laws – there are different socio-economic conditions in different countries, so inevitably there will be variation.”
It isn’t just the variation in the level of consent from healthcare professionals and healthcare organizations, there will also be differences in the way information is published. For example, for some countries (i.e., the Netherlands and the United Kingdom), there is a central database, whereas in other countries the data will be accessible via the websites of individual pharmaceutical companies.
How Are the Countries Coping?
In the United Kingdom, the Association of British Pharmaceutical Industry (ABPI) turned on its centralized database on July 30, 2016, disclosing aggregate spending of £340.3million ($450 million) by over one hundred companies. Most of the payments (67%) involved payments for Research & Development. The other third of payments was for a range of commercial activities, with roughly half of that third going toward a range of service and consultancy fees. Event-related payments (i.e., travel and accommodation) and donations and grants to healthcare organizations.
In the UK, however, roughly one third of physicians featured in the new, public database refuse to be named and some companies have faced difficulties in getting healthcare providers to disclose their own details, outlining some of the difficulties that are likely to continue and plague the EFPIA transparency effort.
Kyriakos Mikellis, President of the Cyprus Association of Research and Development Pharmaceutical Companies (KEFEA), notes that his aim is “to boost the legitimate relationship and cooperation between pharmaceutical companies, healthcare professionals and healthcare organizations, boosting credibility through transparency and making it more comprehensible to patients and all relevant stakeholders.”
In Switzerland, the organization responsible for the implementation of the EFPIA requirements is scienceindustries.ch, the Swiss business association of chemistry, pharmaceuticals and biotechnology. The association coordinated with various pharmaceutical associations and drafted the Pharma Cooperation Code (PCC). The PCC was drafted in an attempt to regulate interactions between pharmaceutical companies, doctors, pharmacists, and other stakeholders, in Switzerland.
EFPIA Intent
According to Powrie-Smith, the goal is not to shame physicians, but instead to “make sure we do whatever we can to make the relationship as transparent as possible, to get consent and get the information in the public domain in a way the public can access it.” He acknowledges the importance of cooperation between industry and health care professionals, but is hoping that this transparency effort will provide an understanding of why such coordination is crucial.